Last week, more than 160 women publicly shared victim impact statements, detailing the horrors they endured at the hands of Larry Nassar, a former team doctor for USA Gymnastics and Michigan State University. It’s nearly impossible to read these statements — even fragments of them — without feeling some sense of horror, disgust, and sadness at what so many young girls faced over the past 20 years.

But it’s also hard not to wonder: How? How did Nassar get away with this for so long? How did so many victims keep their pain quiet? How did these girls bear the burden of this secret? And what makes girls, and all children, so adept at keeping secrets in the first place?

It should be noted, of course, that not all of Nassar’s victims stayed quiet. Some told their parents, or USA Gymnastics officials, or Michigan State University administrators, and were told they were mistaken — they were confusing a medical exam with abuse — or they were simply not believed. But plenty of young victims were forced to hide in plain sight, enduring abuse, sometimes even when their parents were in the room. And while it may seem unimaginable that children could be so adept at keeping secrets that not even their parents suspected anything, experts say it’s quite usual — and that the added stress of elite athletics only compounds the pressure to stay quiet.

“When you look at sexual abuse, period — in adults and kids — delayed disclosure is the norm,” Kristen Houser, spokeswoman for the National Sexual Violence Resource Center, tells Yahoo Lifestyle. “But this is more so in kids. The experience of sexual abuse at the hands of an adult you are supposed to trust is a shocking and confusing experience. We aren’t talking about violent assaults with weapons or things that makes it obvious to children that what’s happening is wrong. When it is done in subtle ways, and especially when we’re talking about, say, a 12-year-old, there are questions of Did that really happen? Did I do something to deserve that? So if you’re not certain why something happened and you feel shame about it, the last thing you want to do is tell someone, because you’re afraid you’ll be blamed, judged, and not believed.”

While all children share this tendency to keep abuse quiet, Houser says that boys and girls may do so for different reasons — with girls having the added pressure of being socialized at a young age to put other people’s needs before their own, potentially compelling them to stay quiet. “Boys may be afraid of being labeled gay,” she says, “where girls may fear not being believed or being called a slut,” she explains.

With her mother by her side, Kayla Spicher, right, delivers a victim impact statement at the sentencing hearing for Larry Nassar, who has been accused of molesting more than 100 girls while he was a physician for USA Gymnastics and Michigan State University. (Photo: Scott Olson/Getty Images)

In addition to the confusion and shame, there is also a stigma when it comes to talking about sexual assault that even children are attuned to, says Katelyn Brewer, CEO of Darkness to Light, a nonprofit aimed at preventing child sexual abuse.

“Individuals are adept at understanding discomfort in other people at a very young age,” Brewer tells Yahoo Lifestyle. “Ours is not a society that makes it comfortable expressing that someone has done something to you that you did not ask for, and we are a society centered around victim blaming. Women who are survivors of sexual assault — women who are over 18 and legally able to defend themselves in a courtroom — are scared to death to speak out if they are sexually assaulted in the workplace. Compound that with an adolescent or a child who is already not self-confident and doesn’t know how to deal with complex situations and potentially hasn’t been told its OK to talk about body parts with trusted adults, and they take it all on themselves.”

As with so many of the sexual abuse cases that have come to light in recent months, power dynamics play an important role when it comes to the abuse of children, and especially the abuse of child athletes.

“When someone who has control over whether or not you succeed, or even whether you are given the permission to compete, it can be terrifying to feel like you’re being put in the place of upsetting that person, and you fear retribution. ‘If I tell, will I stay on the team? What will he say about me to the other coaches or players or teammates?’” Houser says. “Not to mention the extra factor, in this case, that entire families had aspirations about these girls’ careers. It was an environment in which you follow directions and don’t ask questions, a culture of compliance. As a kid you look at all those things on the line and it feels insurmountable.”

Even when kids aren’t athletes, these power issues come into play. “Kids know that adults are more powerful than they are,” Brewer says. “If an adult says you are going to get in trouble if you tell, or that Mommy told me this is OK, kids may be afraid to question that.” In the USA Gymnastics case, she says, the desire to succeed and the “pull yourself up by your bootstraps” mentality only made things harder.

Both experts are hopeful that the press surrounding the victim impact statements in the Nassar trial will help discourage secret-keeping.

“Talking about sexual victimization has become more and more common in our culture,” Houser says. “The more the stigma of talking crumbles and the more people who come forward, the more people will feel like it’s OK to talk. Plus, I think it’s been eye-opening to the public to see how truly life-changing speaking out has been to the victims — to their self-esteem and their aspirations.”

For parents of young children who want to address this head-on, Brewer says families need to start by having a frank conversation about their bodies. “Adults have to be comfortable in their discomfort when talking to their kids. This isn’t an easy topic. You have to be comfortable saying ‘vagina’ and ‘penis,’ and in most social situations that is incredibly difficult, even among adults. But when you talk to kids about anatomy without embarrassment or shame, it instills in them an understanding that there is no shame,” she says. Having the vocabulary to talk about their bodies will ensure there is clarity in a situation where a child is trying to report abuse, Brewer adds.

When it comes to secrets, Brewer says, parents should emphasize communication and safety. “It can help to explain that secrets are best kept when they are surprises, and anything that goes beyond that is probably not a good secret to keep,” she says. “Because this is a topic that so desperately needs the lid blown off.”